Frequently Asked Questions

There are 2 main goals of the peer review program:

• to promote a culture of continuous quality improvement
• to improve your ability to do your job well by linking your peer review to your professional development activities

If called upon to participate in peer review, you have a duty to comply. Except in a limited number of circumstances, participation is not optional. The Nova Scotia Medical Act requires us to conduct peer review and practice assessment.

Peer review information is strictly confidential but not completely anonymous. Only those directly involved in your peer review will have access to the information gathered during the review. This information will be fully protected and will not be shared with other parts of the College.

Family doctors will be the first to participate in peer review and the program will expand over time to include medical and surgical specialists. For now, you will be reviewed only if you have an active clinical component to your practice.

You will be eligible for review at least once every 7 years.

The Physician Peer Review – Nova Scotia (PPR-NS) program includes:

On-Site Review

A trained peer reviewer will visit your practice and follow a standardized process using a selection of practice review tools.

Off-Site Review

Physicians whose practice profiles include protective factors known to promote quality in practice, may be initially directed to have an off-site review. Off-site reviews will include a review of your patient records and an assessment of the quality of care you provide.

The College has been working with other Canadian regulators to better understand the effects of both risk and protective factors on practice quality and physician well-being, and to incorporate this understanding in our peer review program.

A Reflective Approach to Continuing Professional Development

You will be asked to consider your approach to professional development and challenged to adopt best practices for quality improvement in your practice.  The approach is aligned with a new Physician Practice Improvement (PPI) framework developed by the Federation of Medical Regulators of Canada (FMRAC).

Feedback

When you complete the peer review process you will receive both a written report and one-on-one feedback by telephone from your peer reviewer.

At this time, you can ask questions or clarify things found in the review. The focus is on understanding and moving forward with practice improvements.

There are 6 principles that guide the Physician Peer Review Nova Scotia program. They are the following:

• Universality – all doctors can benefit from some form of peer review. Even the best doctors can improve their practice.
• Quality improvement – after a review, you will get specific and meaningful feedback to help you to improve your practice.
• Directive, when necessary – in limited circumstances, such as a review uncovering a safety issue, the program can direct you to take certain actions to improve your practice.
• Best use of resources – program resources will be more heavily focused on those doctors most likely to benefit from peer review.
• Fairness, openness and transparency – we will explain the processes, tools, and standards used by our peer reviewers and ensure they are applied consistently.
• Highly confidential – information gathered during your review will not be shared with other areas of the College (such as Professional Conduct or Licensing) and will be carefully safeguarded by peer review staff.

No. However, as part of your office systems, you are required to maintain the ability to respond to patient requests about who has reviewed their medical records. Our peer reviewers will access and review a selected number of your charts as part of the peer review process.

In the case of paper charts, we advise you to keep a copy of the Record Review Grid that includes the patient records reviewed as part of your peer review.

In the case of electronic medical records (EMRs), you can use the audit trail function in your EMR to determine the charts accessed by your assigned peer reviewer. If you are unsure how to use this function, please contact your EMR supplier directly for instructions.

For specific details regarding your responsibilities as the custodian of your patient health information please consult the “Duties of a Custodian” section within Toolkit for Custodians: A Guide to the Personal Health Information Act.

You can plan to see patients during an off-site review of your practice. In rare instances where your peer reviewer is not able to remotely access the charts you identified for peer review, you may be contacted by peer review staff to ensure the administrative settings and permissions to your EMR are set correctly to allow the peer reviewer proper access.